Claims Resolution Analyst

Gainwell Technologies

Claims Resolution Analyst responsible for processing suspended claims and ensuring adherence to DVHA guidelines. Contributing to claims team success through efficient claims resolution and coordination across departments.

Posted 5/27/2026full-timeRemote • Vermont • 🇺🇸 United StatesMid-LevelSenior💰 $35,000 - $50,000 per yearWebsite

About the role

Key responsibilities & impact

Review and research suspended claims per DVHA guidelines.
Refer claims to the appropriate department for further review when necessary.
Process claim adjustments and corrections as needed.
Prepare and issue Return to Provider (RTP) notices for incomplete or incorrect claims.
Maintain and update claims resolution procedure documentation.
Train backup or replacement staff as needed.
Perform other duties as assigned.

Requirements

What you’ll need

Strong attention to detail and accuracy in claims processing.
Strong reading comprehension skills with the ability to interpret guidelines, policies, and procedures.
Proficiency in Microsoft Excel and Outlook.
Ability to adapt to changing priorities.

Benefits

Comp & perks

generous, flexible vacation policy
401(k) employer match
comprehensive health benefits
educational assistance
leadership and technical development academies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingclaims adjustmentsclaims resolution documentation

Soft Skills

attention to detailaccuracyreading comprehensioninterpretation of guidelinesadaptability